Wednesday, January 15, 2014

how i want to die

One of my "big" resolutions was to start conversations and possibly finalize with Whit the big decisions in our lives: advance directives, wills, guardianship, etc. It's kind of a weird thing on which to be fixated, but I feel that it's better to plan for things when you have the frame of mind to do so impartially. When Whit and I decided to move in together, I pushed us to create a contract to guide us in the event that things fell apart ("That feels so...clinical" said my dad). My thinking is, better to figure out those things when you are calm than when you are hurt and bitter and trying to extract ever drop of revenge out of the entire mess.

We've been discussing guardianship on and off, but since there isn't a clear answer that feels right to us, we decided to skip to something that is actually pretty easy: our advance directives. Also called living wills, it's a document that guides your health care agent and/or medical team towards a plan that most closely matches with what you would decide if you were somehow incapacitated. It's a pretty easy thing to pull together (there are lots of templates online; this is the one we used through Kaiser), but only 25-30% of Americans have one. I assume it's because people don't want to think about dying, or that the decisions that surround it seem very overwhelming. I think of it as it allowing people to have control over their lives and deaths. I'm a very big advocate of individuals having the information and confidence to actively participate in their health care decisions, which allows for true autonomy.

One thing that's really nice about going through this process is having to think about things like what makes life worth living, how much information do you want to know about your condition, what types of interventions do you want (the NY Times had a great piece in November on how doctors make decisions for their end-of-life care, knowing what they know about death and dying; here is another one).

Maybe the feeling that occurs after the process -- that you've somehow regained control over your death -- is hubris, but at least I feel like I've left an idea of how I'm trying to get there.